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Approach to Care

Living with, supporting and caring for a person with a dementia diagnosis can be very challenging, particularly if your loved one begins acting out or becomes aggressive or agitated while you are caring for them. One of the biggest questions that arises for a caregiver in these situations is “why?”  “Why are they upset?” “Why are they acting this way?” “Why can’t they sleep?” Why, why, why.

Obviously being in the role of caregiver can become very stressful, especially when you can’t be certain what is needed to help your loved one feel better, sleep, eat or just relax. While it can be challenging at times as the caregiver, the best thing you can do is try to understand what is causing the behavior.

Concerning Behaviors

Here are some items to consider:

  • Is your loved one exhibiting a new behavior?
  • Can you determine what is causing the behavior?
  • Is your loved one hungry, tired or need to use the restroom?
  • Are they too warm/cold?
  • Are they physically ill/not feeling well?

First and foremost, it’s important to realize that as with many human interactions, people change. Their responses may be different than you expect – especially when you factor in an Alzheimer’s or dementia diagnosis. It is important to realize that you may not always resolve a situation in the same way. It is also vital for you, as the caregiver, to understand that your loved one may no longer feel a connection with you as a wife, daughter or friend. The progression of their disease may have taken away their memory of you as that special person in their life. They may see you simply as a friendly acquaintance or even, a complete stranger. Try not to take offense to this, rather focus on caring for them in the moment, whomever they think you are.


Remembering that a positive approach is key, consider the following advice:

  1. Present yourself in a positive manner, explaining how you plan to help. Make sure you are using a calming voice, and make eye-contact. A smile can go a long way in creating a positive interaction. If they are in a wheel chair, or seated, kneel down, to engage them at a height that is equivalent to theirs, so that you aren’t “talking down” to them. It’s also important to remember that people “mirror” the behaviors that they are presented. If you present a positive, smiling, friendly manner, that response will likely be returned by your loved one.
  2. Oftentimes, those with dementia can feel scared, anxious or fearful when someone gets close to them. It’s a natural reaction to someone entering their personal space. Imagine how you feel when someone you don’t know gets extremely close to you. It can be quite uncomfortable or unsettling. This is what it can be like for your loved one, considering they may no longer recognize who you are. Remember to use calming body language and a gentle touch. Some loved ones respond well to a gentle rub on the upper back/shoulders to relax. Simply holding hands can put someone at ease, as well.
  3. It is critical that you let the loved one know what you are doing and how you plan to help them. Use simple, direct statements. Keep your communication short, and to the point. Short, direct phrases like “time to shower” or “let’s wash your hair” are recommended. It is important to consider their potential anxiety, and how you can reduce that by simply sharing your intentions. It is much better for them to know that you are there to help, and how you plan to provide assistance than for them to let their fear and imagination take over. Also, important for you, as the caregiver, to remember, is that these verbal cues should become a habit. No matter how many times the direction is given, when short term memory has been affected, your loved one will likely have little or no ability to retain these directions from one time to the next.
  4. Involve your loved one in as much social/engaging activity as possible throughout the day. It is important for them to feel the sense of belonging and purpose. If possible, have them join in an activity with you – it can be as simple as helping to fold wash cloths or hand towels. Items that can be handled easily should be used, to give them the feeling of contributing and being helpful. You’ll find that if your loved one is busy or involved in an activity, they are less likely to act out or get restless. It’s also important for you to change your expectations, focus on simply being present and in the moment. Don’t worry about how the perfectly or imperfectly the towels end up. What is important is being present and engaged with your family member.
  5. If you feel that they are in need of personal assistance – using the restroom, dressing or otherwise, bring your family member to a space that is conducive to providing care. Consider their dignity and sense of privacy. It is imperative to communicate how you intend to help the person during an activity involving personal care. Your loved one may feel vulnerable or nervous in these situations. It is critical to let them know what you are doing to help them by verbalizing your activities. Sometimes changing the environment can also bring calm and peace to someone who might otherwise be acting out. Maybe what is needed is a quieter, more private space to relax.

Keep a Journal

Taking stock of your loved ones overall condition will help you narrow your focus to probable causes for any type of behavior/acting out that may be occurring. A great practice to begin is to keep a journal of behaviors and related causes which will help you in the future to find a resolution more quickly. Also, how you approach your loved one during a time of discontent, will make all the difference.

Considering the approach advice above, here are some key items to include in your log or journal:

  • Behavior
  • Stimulation/activity
  • Time of day
  • Environmental situation (is the room too warm/cold, too bright/too dark)
  • Visitors/other people present
  • Cause of behavior
  • How did you resolve the behavior

In the future, you can reference your behavior log and have some ideas regarding what has worked in the past. Overall, approaching your loved one positively and establishing routines will help you and your family member bring calm to the situation more quickly.

Journaling behaviors is one of the most effective ways that you can ensure that you are responding in the same way as in the past. In fact, we utilize behavior tracking tools with our Maplewood Senior Living residents as well.

It’s OK to Ask for Help

Obviously, your intention is to provide the help that your loved one needs for as long as possible. However, it is also just as important to remember that you are permitted to ask for help. Caregiving for a loved one with dementia can be very challenging and stressful. It commonly takes a toll on the caregiver – physically and emotionally. If you have reached this point, it’s important to remember that there are people out there to help you.

All Maplewood Senior Living communities offer Support Groups, free and open to the public. Attend regularly, or just when you feel you need that extra help or support. These sessions provide an open forum for caregivers to discuss ideas, offer each other advice, and establish a sense of community, as it is so important to remember that you are not alone on this journey. Contact us for more information on upcoming support groups at Maplewood Senior Living.

Assistance comes in many forms, as well. And, our Maplewood Senior Living communities can take care of your loved one when it becomes too cumbersome for you and your family to manage on your own. It’s important for you to remember to take care of yourself and sometimes that means it’s actually physically and emotionally better for you to have others handle the “heavy lifting” of caregiving. Contact us to learn more about how Maplewood Senior Living may be able to help you and your loved one.

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